Apple Tree Arts
Application for Tuition Assistance
(CONFIDENTIAL)
Please print, complete and mail form to:
Apple Tree Arts, P.O. Box 75, Grafton MA 01519
Student Name ______________________________________________________ Age ________________
Address __________________________________________________________________________
Phone # _______________________________ Number of Children in Family ___________________
Mother's Name ____________________________________ Work Phone # ________________________
Employer ____________________________________ Yearly Salary ________________________
Father's Name ____________________________________ Work Phone # ________________________
Employer ____________________________________ Yearly Salary ________________________
Income from other sources ___________________________ Total Family Income____________________
Please tell us why you feel tuition assistance is necessary __________________________________________
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Class or program applying for ___________________________ Amount Affordable _____________________
Please understand upon receipt of this assistance, that it is your responsibility to assure that your child attends class regularly and you will pay the rest of the tuition on time. Enrollment may be dropped if regular absences occur. We also request, if possible, for you to be a volunteer at any concerts or other programs we may have. Applications must be updated each semester.  
 
Signature of Parent/Guardian _______________________________________________ Date _____________
I agree that the above information is truthful and accurate.
If the information is found to be incorrect, assistance will be stopped.